Meter Swap � _ '
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City of Fridley
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� Water Deuartment
. Address ��� � ( 1'"� �-� �.� _
Name � ��'�� T �C� I,e _
Date I ���"� �
Old Meter Number b � t ��o �
Old Meter Reading �a 6 6 $� _ -
' Replacement No. � ��,?t 7
Replacement Reading � ,
. Replacement Make Va-d {-r
. , ; Remarks: �/G1F /7I� r' _ �
Signe
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U.noF AUTOMATIC METER READER
Fr�n��r
Address ���� " / =� �(
Name .�./�i��� �lJL,;t=
Date �" {.�''1�
Old Meter Number ��
Old Meter Readin —1 �D �ot�
Replacement No. ��
Replacement Reading �
Replacement Make�_�
ERT# �� Jl� c���� �
Replacement ERT#
Remarks:
1�SSigned:
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City of Fridley
Water Department
6431 University Avenue NE
Fridley,MN 55432
(763j572-3566
I/we hereby authorize the City of Fridiey and/or its
empioyees to do what is necessary to reptace the water meter. I understand that the property owner
is liable for the water line from the main to the premise and a{I interiar plumbing. (Per City code
402.Q6) i alsa hoid the City af F�idley and/its empioyees harmless for any damages that may occur
while doing this operation. This to inciude,but nat limited to;valves,piping,walls,floors or the curb
stop bax and service line. I understand I am also required to obtain a permit prior to any work,if
necessary.
Ftnal meter reading(old meter) _\,�� / ��LJ
Name� Address• �4J J� 1 ` ����
Phone Number� e: �'"✓'� U` --
Signature: ��
Witness Signature: �
FRIDLEY CITY C�DE
CHAPTER 402.WATER,S70RM WATER,AND SANITARY SEWER
ADMINIS7RATION
(Ref Ord No 113,464,565,566,629,638,662,922,988, 1144, 1156, 1191j
402.05. PERMIT FEE
Prior to constructing or repair of any water or sewer line connecting the existing municipal system and any house
or building for which the application is made,the awner or contractor shall be required#o obtain a permit for such
connectian,and shall pay a permit fee as provided in Chapter 11 of this Code. After such connection has been
made,the Water and Sewer Department shall be natified. It shall be unlawful to cover any connecting line until an
inspection has been made and such connection and the work incident thereto has been approved by the City as a
proper and suitab{e connection.
402.06. REPAIRS AND MAINTENANCE TO CONNECTION
After the initial connection has been made to the water service curb stop box or the sewer lead at the property
line or a water service or sewer lead has been extended to the property line for connection,the applicant,owner,
or the occupant ar user of such premises shalt be tiabie for a11 repairs required to any water fine and sewer lines
necessary for connection of the premises from the main to the premises. If the property owner requests
maintenance service or repairs be performed by the Gity,the property owner shall be charged for the costs of the
maintenance and/or repairs, including any necessary street repairs,at a rate set annually by an administrative
policy. It shall be the responsibility of the applicant,owner,occupant or user to perform standard maintenance of
the sewer service line from the premises to the main inciuding debris clearing or root cutting and to maintain the
water service curb stop box for operability and at such height as wilt ensure that it remains above the finished
grade of the{and or praperty. (Ref 638,1156,1191)